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NPI Code Detail

MEDICARE: MICHAEL BANES

MEDICARE:   MICHAEL  BANES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376G00000XNursing Home Administrator11686

General Provider Information

NPI Number : 1033731211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL BANES
Provider Business Mailing Address
First Line : 1599 LOMALAND DR
Second Line :
City : EL PASO
State : TX
Zip : 79935-4201
Country : US
Telephone Number : 228-806-6322
Fax Number :
Provider Business Practice Location Address
First Line : 1599 LOMALAND DR
Second Line :
City : EL PASO
State : TX
Zip : 79935-4201
Country : US
Telephone Number : 228-806-6322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2020
Last Update Date : 05/11/2020

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Directions to “ MICHAEL BANES ” Practice Location

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